ArticleBMC health services research2024
Efficiency evaluation and promoter identification of primary health care system in China: an enhanced DEA-Tobit approach.
Article in BMC health services research, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 10 papers.
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10 citing papers in PubMed.
- A core competency framework for healthcare workers to deliver basic public health service in primary healthcare settings in China.Communications medicine · 2026Article
- The impact of digital economy on primary healthcare institution efficiency: evidence from China based on spatial effect analysis.BMC primary care · 2026Article
- Carbon emission governance and public health efficiency in transitional China: Regional differences and spatial aggregation.PloS one · 2026Article
- Balancing efficiency and clinical quality in dialysis centers: Insights from a nationwide DEA study in Taiwan.PloS one · 2026Article
- Efficiency assessment and demand forecasting in China's primary healthcare system: a comprehensive SBM-DDF-GML analysis.Frontiers in public health · 2026Article
- Measuring the effect of deprivation on primary health care performance using data envelopment analysis and Malmquist Indices.Health care management science · 2025Article
- Efficiency analysis of primary health care resources: DEA and Tobit regression evidence from village clinics in Jiangsu Province.Frontiers in public health · 2025Article
- How efficient are specialized public health services in China? A data envelopment analysis and geographically weighted regression approach.Frontiers in public health · 2025Article
- Coupling coordination and regional health equity: an empirical study of economic, social, and healthcare systems in Zhejiang Province, China.Frontiers in public health · 2025Article
- Evaluation of Health Resource Efficiency and Its Influencing Factors in Ethnic Minority Areas of Guangxi: Data from 2010 to 2022.Risk management and healthcare policy · 2025Article
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Abstract
backgroundWith Primary Health Care (PHC) being a cornerstone of accessible, affordable, and effective healthcare worldwide, its efficiency, especially in developing countries like China, is crucial for achieving Universal Health Coverage (UHC). This study evaluates the efficiency of PHC systems in a southwest China municipality post-healthcare reform, identifying factors influencing efficiency and proposing strategies for improvement.
methodsUtilising a 10-year provincial panel dataset, this study employs an enhanced Data Envelopment Analysis (DEA) model integrating Slack-Based Measure (SBM) and Directional Distance Function (DDF) with the Global Malmquist-Luenberger (GML) index for efficiency evaluation. Tobit regression analysis identifies efficiency determinants within the context of China's healthcare reforms, focusing on horizontal integration, fiscal spending, urbanisation rates, and workforce optimisation.
resultsThe study reveals a slight decline in PHC system efficiency across the municipality from 2009 to 2018. However, the highest-performing county achieved a 2.36% increase in Total Factor Productivity (TFP), demonstrating the potential of horizontal integration reforms and strategic fiscal investments in enhancing PHC efficiency. However, an increase in nurse density per 1,000 population negatively correlated with efficiency, indicating the need for a balanced approach to workforce expansion.
conclusionsHorizontal integration reforms, along with targeted fiscal inputs and urbanisation, are key to improving PHC efficiency in underdeveloped regions. The study underscores the importance of optimising workforce allocation and skillsets over mere expansion, providing valuable insights for policymakers aiming to strengthen PHC systems toward achieving UHC in China and similar contexts.
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